| NPI | 1265241699 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13151) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX PA19666) |
| Enumeration Date | 2024-12-31 |
| Last Update Date | 2025-10-28 |